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Contact Information

DIVINE PSYCHOLOGY, LLC
4343 SHALLOWFORD RD STE G3
MARIETTA, GA30062-5021
 Phone: 678-626-7207
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Health

103TH0004X 62 Psychologist, Clinical
 

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DIVINE PSYCHOLOGY, LLC

NPI Number 1003320888
LBN Legal business name DIVINE PSYCHOLOGY, LLC
Authorized official SARA VELEZ - (CLINICAL PSYCHOLOGIST & OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/01/2017
Last updated 05/28/2021 - About 5 years ago
Identifiers
GA License # PSY003469
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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